Can a medieval mystic’s ascetic practice shed light on why people voluntarily starve themselves today? Masako Fukui compares the life of Saint Catherine of Siena to that of Kate—a young woman struggling with anorexia nervosa in 21st century Australia.

In 1380, a young woman starved herself to death, but her refusal to eat was regarded as a form of religious asceticism. She was later canonised, and became Saint Catherine of Siena.

In 2013, a young woman starves herself to death, but rather than saintly regard, she’s considered to be mentally ill, a victim of insidious media images encouraging impossible thinness. Is it just historical context that separates these two cases? Can a medieval mystic’s ascetic practice shed light on why people voluntarily starve themselves today?

Certainly, historical context partly explains the difference between how these two lives are interpreted. In secularised 21st century Australia, ascetic practices such as ritual fasting are no longer integral to our lives. So we’ve all but lost the connection between acts of bodily discipline and our inner lives that Christian mystics understood so well. To them, actively controlling food intake was a link to spiritual nourishment, a way to feed the soul. And for Catherine, who also used bodily mortification, physical suffering was a way to ultimately fuse with the suffering of Christ.

St. Catherine disciplined her body for a higher religious purpose. What is the covert longing that lies suppressed in Kate or young women like her? To ask this question is, in my view, the only real start to understanding the will to not eat, and eventual recovery from Anorexia.

Masako Fukui, documentary maker

In contrast, Anorexia Nervosa is defined today as an individual pathology, a clinical entity to be cured. Feminists are critical of this reductionist approach. But like the medical model, the feminist claim that Anorexia has socio-cultural origins also assumes a passive 'anorexic body' upon which illness strikes, or cultural meanings about gender are inscribed.

But are women with Anorexia (the majority are still female) merely docile victims of oppressive media images that feminists like Naomi Wolf, author of the influential The Beauty Myth would lead us to believe? Is there a place for women’s agency or autonomy?

After listening to and been moved by personal narratives of women with Anorexia, I suspect that much like the 'holy anorexics' before them who starved to be closer to God, women who starve themselves today are also attempting to mould their inner selves through extreme control of their bodies.

29 year old Kate has had an eating disorder since she was a teenager. Kate’s recent journal entries, written while in hospital for treatment for Anorexia, are full of self-loathing. 'I’m so fat and disgusting,' is a common refrain.

But dig deeper into her narrative, and it’s evident that self control is a recurrent theme: 'I need to get the control back, I know I can,' she chides herself. At face value, this control is over her body through the restriction of food. But for Kate, who also suffers from depression and anxiety, exerting control over her body is about taking control of her emotions.

First hospitalised for eating disorders not long after leaving school, Kate thinks she had 'a bit of a nervous breakdown' around that time. 'It was massive, massive life change leaving school. And I never really got over it I guess.' She explains that her eating disorder is a form of self control that she needs to keep feelings of depression, fear, shame, dependency and inadequacy from overwhelming her.

There is a vast array of narratives like Kate’s all over the internet. While some sites are clearly 'pro-ana' or 'thinspiration' sites that encourage dangerous behaviours, most are genuine stories of young people attempting to make sense of the life-threatening grip Anorexia exerts.

Some people starve themselves as a form of self-punishment, some are expressing a fear of sexuality and some are trying to deal with the pain of childhood abuse. The stories are as varied as there are many, and to try to subsume all these narratives into one category such as fear of gaining weight is much too simplistic and reductionist. More crucially, it prevents any discussion of what the extreme anorexic behaviour is ultimately directed at.

But if we just allow ourselves to think of Anorexia as misplaced ancient asceticism, then the longing to control or reshape some part of the self comes to the fore. St. Catherine disciplined her body for a higher religious purpose. What is the covert longing that lies suppressed in Kate or young women like her? To ask this question is, in my view, the only real start to understanding the will to not eat, and eventual recovery from Anorexia.

Theologian Margaret R. Miles who’s written extensively on medieval women, asks a pertinent question: could it be that 'fasting girls and women experience an imbalance between the body’s ‘size’ and the interior life?' Perhaps the 'soul' or the inner life of young people is not encouraged enough or allowed to develop?

So the really big and perhaps most important question we need to ask is, how can we reshape society so that women and men do not feel compelled to starve to death?

Again, Catherine of Siena’s life offers a clue. As medieval historian Caroline Walker Bynum has pointed out, Catherine’s extreme fasting was a way to manipulate her male dominated environment so that she could live the life of Christian piety and devotion she so longed for. But perhaps if the medieval Church (or the current one for that matter) were not so anti-women, Catherine may have had a legitimate role in the Church, and not had to starve herself to death in order to become closer to God.

Anorexia is indeed a frightening illness that seems quite resistant to the plethora of current clinical interventions and theorising. Perhaps if we paid less attention to women’s bodies and more attention to her inner subjectivity, we might make some inroads into helping those like Kate lead a fuller life.